Characterizing Pain & Associated Coping Strategies in Methadone & Buprenorphine Maintained Patients

Highlights

• Many opioid maintenance treatment (OMT) patients report chronic pain that is of significant severity and interference in their life.
• Most OMT patients with concurrent chronic pain are utilizing few evidenced-based pain coping strategies.
• Methadone patients reported greater severity pain, though interference from pain in daily activities did not vary as a function of OMT.

Chronic pain is common among patients receiving opioid maintenance treatment (OMT) for opioid use disorder. To aid development of treatment recommendations for coexisting pain and opioid use disorder, it is necessary to characterize pain treatment needs and assess whether needs differ as a function of OMT medication.

A point-prevalence survey assessing pain and engagement in coping strategies was administered to 179 methadone and buprenorphine-maintained patients.

Forty-two percent of participants were categorized as having chronic pain. Methadone patients had greater severity of pain relative to buprenorphine patients, though both groups reported high levels of interference with daily activities, and participants with pain attended the emergency room more frequently relative to participants without pain. Only 2 coping strategies were being utilized by more than 50% of participants (over-the-counter medication, prayer).

Results indicate that pain among OMT patients is common, severe, and of significant impairment. Methadone patients reported greater severity pain, particularly worse pain in the past 24 hours, though interference from pain in daily activities did not vary as a function of OMT. Most participants with pain were utilizing few evidenced-based pain coping strategies. Increasing OMT patient access to additional pain treatment strategies is an opportunity for immediate intervention, and similarities across OMT type suggest interventions do not need to be customized to methadone vs. buprenorphine patients.

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By: Kelly E. Dunn, Patrick H. Finan, D. Andrew Tompkins, Michael Fingerhood, Eric C. Strain

Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine

  

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